title: Prognostic factors after complete resection of pN2 non-small cell lung cancer.
abstract: OBJECTIVE
  This retrospective, multicenter study aimed to determine prognostic factors of completely resected pathologic N2 stage IIIA non-small cell cancer (NSCLC).
  
  
  METHODS
  From 25 participating hospitals, 496 patients (325 men and 171 women; median age, 65 years) who underwent complete resection without preoperative treatment for pT1-3 N2 M0, stage IIIA NSCLC between 2000 and 2004 were enrolled. Lobectomy/bilobectomy was performed in 462 patients and pneumonectomy in 34. Some kind of adjuvant chemotherapy was administered to 296 patients. Survivals were calculated using the Kaplan-Meier method, and prognostic factors were determined using the Cox proportional hazards model.
  
  
  RESULTS
  Five-year overall survival (OS) and disease-free survival (DFS) were 44.8% and 24.2%, respectively. pT classification (hazard ratio (HR), pT1/pT2/pT3 = 1/1.32/2.03), single or multiple N2 metastases (HR, single/multiple = 1/1.36), and skip or nonskip N2 metastasis (HR, skip/nonskip = 1/1.30) were found to be independent prognostic factors for DFS. Sex (HR, female/male = 1/1.36), performance status (HR, PS-0/PS-1 = 1/1.37), tumor diameter (HR, 1.12 per 1-cm increase), pT-factor (HR, pT1/pT2/pT3 = 1/1.37/2.22), and extent of N2 metastasis (HR, localized/extended = 1/1.39) were shown to be independent prognostic factors for OS.
  
  
  CONCLUSIONS
  We found that pT classification was a significant prognostic indicator for OS and DFS whereas tumor diameter, performance status, and sex were ones for OS. Single N2 metastasis and skip N2 metastasis were demonstrated as favorable prognostic factors for DFS, limited N2 metastasis was one for OS, and these should be considered as stratification factors for trial on adjuvant therapy.
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Kyoto.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sonobe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
authors.forename: Hiromi
authors.initials: H
authors.lastname: Wada
authors.forename: Kenichi
authors.initials: K
authors.lastname: Okubo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hamakawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teramukai
authors.forename: Akihide
authors.initials: A
authors.lastname: Matsumura
authors.forename: Tatuo
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Sumitomo
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Norihito
authors.initials: N
authors.lastname: Okumura
authors.forename: Sadanori
authors.initials: S
authors.lastname: Takeo
authors.forename: Kenzo
authors.initials: K
authors.lastname: Kawakami
authors.forename: Minoru
authors.initials: M
authors.lastname: Aoki
authors.forename: Shinji
authors.initials: S
authors.lastname: Kosaka
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: 10; 10.4; DFS; ECOG; EGFR; Eastern Cooperative Oncology Group; HR; IV-CT; JMTO; Japan-Multinational Trial Organization; NSCLC; OS; PS; UFT; c; clinical; disease-free survival; epidermal growth factor receptor; hazard ratio; intravenous chemotherapy; non–small cell lung cancer; operative survival; p; pathologic; performance status; tegafur-uracil